Seven years of war in Syria have taken a catastrophic human toll and created one of the worst humanitarian crises of our time.

Well over 4,000 Syrians have been reportedly killed or injured in Eastern Ghouta since mid-February, despite the United Nations Security Council passing a resolution on Feb. 24 that demanded a month-long ceasefire. From the carnage in Eastern Ghouta to the hundreds of thousands uprooted in Idlib, the war in Syria has no end in sight.

Drawing on insights from International Rescue Committee and partner aid workers inside Syria, as well as reports from people we’re helping on the ground, here are seven things you need to know about the crisis.

Syrian civilians run for cover after a bomb hits Eastern Ghouta in the suburbs of Damascus.

Photo: Abdulmonam Eassa/AFP

1. Nearly 10,000 Syrians are fleeing from violence each day.

6.1 million Syrians remain displaced within their country. In northwest Syria, civilians in Idlib are bearing the brunt of the fighting. The province is home to 2.6 million people, nearly half of whom are displaced from elsewhere in Syria. Even in areas like Eastern Ghouta, in the suburbs of Damascus, up to 15,000 people have been displaced by recent waves of brutal violence. Once home to over one million people, those who remain endured eight weeks of the same deadly tactics used in the 2016 bombing of East Aleppo: siege, starve and bombard.

“Everything happened so suddenly—a big, loud, low-pitched sound came out of nowhere. Then one bomb hit our neighbor’s house,” an Eastern Ghouta resident told the IRC. “Seconds after, I started to hear the shelling. It caused fear in our hearts. My family screamed and panicked.”

2. The health system in Syria has collapsed.

Three quarters of Syria’s doctors and medical workers have fled the country and half of all medical facilities have been destroyed or put out of action. Those who remain risk daily airstrikes and have been forced to operate without sufficient electricity, equipment or medicine. Some lack the training and experience to deal with the most critical injuries.

A doctor and nurse weigh a malnourished baby at an IRC-supported clinic in Eastern Ghouta run by a local partner. Photo: Abdullah Hammam/IRC

In Eastern Ghouta, people were afraid to travel to seek treatment and it’s too dangerous to deliver fuel and other essentials to health clinics. Around a dozen local medical facilities have been attacked in recent weeks, including two IRC-supported hospital and clinics, resulting in the deaths of patients and staff.

Restrictions on aid convoys mean the injured were dying unnecessarily without antibiotics to treat infections. Even pain-relievers are scarce.

“All ambulances are short of critical medical supplies,” says a Syrian paramedic who worked with a former IRC local partner in Eastern Ghouta. “We have the basics such as blood pressure machines, thermometers, stretchers and first aid materials like bandages. But often, the material is of bad quality.”

Eastern Ghouta now has just one doctor per 3,600 people. More than 1,000 residents with serious medical conditions such as cancer, kidney failure, heart disease and critical war injuries are on a list for urgent medical evacuation—a list that does not include other terminal illnesses or senior citizens.

3. Syrian children are not going to school.

Some 1.75 million children and youth in Syria do not attend school, with many more at risk of dropping out to provide for their families or because of the danger.

Mahmoud, a 13-year-old from Homs who now lives in Lebanon, braved the daily trip to his local school until it was destroyed by a bomb. “I was scared to be killed, but it’s school…I had to go,” he recalls. “I had no desire to stay in the dark, even if there’s war around me.”

More than a third of schools in Syria have been damaged or destroyed, and hundreds of thousands of teachers and professors have fled the country.

4. Over 3 million Syrian children under 5 don’t have enough food to eat.

A man sells filtered water in Irbin, Eastern Ghouta where the price of water has risen sharply because of the high costs of fuel. Photo: Abdullah Hammam/IRC

Farms and crops destroyed by violence and aid convoys blocked from entering cities have created a food crisis that has pushed two million people in Syria to the brink of starvation. Many families are forced to eat expired food, animal feed, and even trash—or go without. As of October 2017, 1,000 Syrian children in Eastern Ghouta are suffering from malnutrition. Food prices are on average five times higher than elsewhere in Syria—the cost of bread has increased by 1,500 percent.

The war has also wreaked havoc on the country’s economy. Over half of Syrians are unemployed and living in poverty. Faced with skyrocketing fuel prices, people are burning their clothes, furniture and tires for heat. Families are spending up to 15-20 percent of their income just on clean water.

5. The death count in Syria keeps rising.

Nearly 500,000 Syrians have been killed since 2011. Over eight million people live close to explosives—there are 4,000 casualties reported every month. Last month’s bombing campaign in Eastern Ghouta caused over 500 deaths in less than a week and a suspected chemical attack in the town of Douma claimed more than 70 lives. It was one of the war’s bloodiest moments since last April, when a chemical weapons attack in southern Idlib killed some 100 people and sparked international outrage.

Although certain parts of Syria were designated so-called “de-escalation areas” to help reduce violence, this move did not see a reduction of violence during 2017. In fact, some de-escalation areas such as Idlib and Eastern Ghouta are experiencing spiraling attacks.

6. Syrians can’t go home.

Half of Syria’s population has been forced out of the country. The tragedies still unfolding across Syria are a stark reminder to these refugees that it is still not safe to return to Syria. Entire neighborhoods remain littered with unexploded bombs, cluster munitions, grenades, mortars, rocket shells, and even “booby traps” rigged to detonate on contact.

“I was called to rescue a seven-year-old child who had been playing on the balcony of his house,” recalls the Syrian paramedic in Eastern Ghouta. “He came across a bomb—which exploded. His body was a heap of flesh without bones.”

The 5.5 million Syrians who have fled to neighboring countries are struggling to survive with limited access to legal work, affordable health care and schools—and those who had been approved for resettlement in the United States are no longer welcome.

The Trump administration has slashed the number of refugees allowed to enter the U.S. From October 2017 to January 2018, the number of resettled Syrian refugees dropped by almost 100 percent. And a humanitarian program that allowed 6,900 Syrians who have temporary protected status in the U.S. to remain in the country for 18 more months has not been extended to those who arrived after them.

A bombed school in Douma, Eastern Ghouta. About a quarter of children in Eastern Ghouta are unable to get to school.

Photo: Abdullah Hammam/IRC

7. There is something you can do to help Syrians get through this crisis.

Whether it’s by raising your voice, welcoming refugees or making a generous donation, you can make a difference:

Across Syria, the International Rescue Committee provides lifesaving support to 1.1 million people—almost half of them children—who are struggling to survive a brutal war. The IRC supports local medical and health facilities and mobile health teams. We also distribute emergency cash to enable the most vulnerable families to buy food, water, and other essentials. The IRC is also partnering with Sesame Workshop on educational programs to help children inside Syria and across the region recover from the crisis and reach their full potential. Learn more about our work.